The burden of psychological distress in stroke survivors: a systematic review and meta-analysis of sociodemographic and behavioral factors.

Authors

Jiali Chen, Yihao Wang, Ziyu Zhang

Published in

Frontiers in public health. Volume 14. Pages 1930488. Epub Sep 28, 2026.

Abstract

Psychological distress is a common yet frequently overlooked complication among stroke survivors, significantly impacting their recovery and long-term prognosis. Identifying the prevalence and key psychosocial determinants of this condition is essential for developing effective mental health support strategies. However, the existing evidence remains fragmented. Therefore, a systematic review and meta-analysis are urgently required to consolidate current evidence on the prevalence and risk factors of psychological distress in stroke survivors. This synthesis will serve as a pivotal reference for optimizing clinical management and shaping future healthcare policies.
To systematically evaluate the prevalence of psychological distress among stroke survivors and identify the associated sociodemographic and psychosocial risk factors.
Eight databases were systematically searched for observational studies from January 2019 to February 2026. The search terms were "Stroke" "Psychological Distress" and "Emotional Distress." The Agency for Healthcare Research and Quality (AHRQ) was used to evaluate the study quality, and the meta-analysis was performed using R4.3.2 software.
A total of 22 observational studies involving 15,370 stroke survivors were included in this review. The pooled prevalence of psychological distress was 51.97% [95% CI: 37.79, 66.15%]. Meta-analysis revealed that protective factors against distress included receiving social support (r = -0.37, p < 0.0001), the utilization of effective coping strategies (r = -0.47, p < 0.0001), and having a spouse (OR = 0.78, p = 0.0255). Conversely, higher levels of distress were significantly associated with lower income (OR = 6.69, p = 0.0044) and increased levels of disease-related stigma (r = 0.61, p < 0.0001). Furthermore, maladaptive coping mechanisms, such as avoidance (r = 0.48, p < 0.0001) and submission confrontation styles (r = 0.61, p < 0.0001), were identified as significant contributors to psychological morbidity.
Psychological distress is highly prevalent among stroke survivors. Our findings identify social support, marital status, income, and coping mechanisms as pivotal determinants of psychological distress in stroke survivors. These results underscore the necessity of integrating targeted, multidisciplinary interventions into routine post-stroke care to alleviate distress and enhance long-term quality of life.
Identifier https://www.crd.york.ac.uk/PROSPERO/view/CRD42024570838.

PMID:
42865790
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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